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  1. Article ; Online: Bronchoscopy on Intubated Patients with COVID-19 Is Associated with Low Infectious Risk to Operators.

    Gao, Catherine A / Bailey, Joseph I / Walter, James M / Coleman, John M / Malsin, Elizabeth S / Argento, A Christine / Prickett, Michelle H / Wunderink, Richard G / Smith, Sean B

    Annals of the American Thoracic Society

    2021  Volume 18, Issue 7, Page(s) 1243–1246

    MeSH term(s) Bronchoscopy ; COVID-19 ; Humans ; Personal Protective Equipment ; SARS-CoV-2
    Language English
    Publishing date 2021-01-15
    Publishing country United States
    Document type Letter ; Research Support, N.I.H., Extramural
    ZDB-ID 2717461-X
    ISSN 2325-6621 ; 1943-5665 ; 2325-6621
    ISSN (online) 2325-6621 ; 1943-5665
    ISSN 2325-6621
    DOI 10.1513/AnnalsATS.202009-1225RL
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Bronchoscopy on Intubated COVID-19 Patients is Associated with Low Infectious Risk to Operators at a High-Volume Center Using an Aerosol-minimizing Protocol.

    Gao, Catherine A / Bailey, Joseph Isaac / Walter, James M / Coleman, John M / Malsin, Elizabeth S / Argento, A Christine / Prickett, Michelle H / Wunderink, Richard G / Smith, Sean B

    medRxiv : the preprint server for health sciences

    2020  

    Abstract: ... to perform over 450 BALs on intubated COVID-19 patients. We therefore sought to describe the subsequent ... that they received. Participants were asked to assess the difficulty of BAL on intubated COVID-19 patients ... on intubated COVID-19 patients with aerosol-limiting precautions, our survey of bronchoscopists found no ...

    Abstract Background: The coronavirus disease 2019 (COVID-19) pandemic raised concern for exposure to healthcare providers through aerosol generating procedures, such as bronchoalveolar lavage (BAL). Current society guidelines recommended limiting use of BAL to reduce operators' risk for infection, yet data on the infection rate for providers after BAL is sparse. Since March 2020, our institution used a modified protocol to perform over 450 BALs on intubated COVID-19 patients. We therefore sought to describe the subsequent infectious risks to providers associated with BAL.
    Methods: Fifty-two pulmonary and critical care providers (faculty and fellows) at our tertiary-care, urban medical center were surveyed. Survey participants were asked to provide the number of BALs on COVID-19 patients they performed, the number of weeks they cared for intensive care unit (ICU) patients with COVID-19, and the results of any SARS-CoV-2 testing that they received. Participants were asked to assess the difficulty of BAL on intubated COVID-19 patients as compared to routine ICU BAL using a numeric perceived difficulty score ranging from 1 (easier) to 10 (harder).
    Results: We received forty-seven responses from fifty-two surveyed (90% response rate), with 2 declining to participate. Many respondents (19/45, 42%) spent >5 weeks on an ICU service with COVID-19 patients. The number of BALs performed by providers ranged from 0 to >60. Sixteen of the 35 providers (46%) who performed BALs underwent at least one nasopharyngeal (NP) swab to test for SARS-CoV-2, but none were positive. Twenty-seven of the 35 providers (77%) who performed BALs underwent SARS-CoV-2 serology testing, and only one (3.7%) was positive. Respondents indicated occasionally not being able to follow aerosol-minimizing steps but overall felt BALs in COVID-19 patients was only slightly more difficult than routine ICU BAL.
    Discussion: At a high-volume center having performed >450 BALs on intubated COVID-19 patients with aerosol-limiting precautions, our survey of bronchoscopists found no positive NP SARS-CoV-2 tests and only one positive antibody test result. While the optimal role for COVID-19 BAL remains to be determined, these data suggest that BAL can be safely performed in intubated COVID-19 patients if experienced providers take precautions to limit aerosol generation and wear personal protective equipment.
    Keywords covid19
    Language English
    Publishing date 2020-09-02
    Publishing country United States
    Document type Preprint
    DOI 10.1101/2020.08.30.20177543
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Bronchoscopy on Intubated COVID-19 Patients is Associated with Low Infectious Risk to Operators at a High-Volume Center Using an Aerosol-minimizing Protocol

    Gao, Catherine A. / Bailey, Joseph Isaac / Walter, James M. / Coleman, John M. / Malsin, Elizabeth S. / Argento, A. Christine / NU Covid Investigators / Wunderink, Richard G. / Smith, Sean B.

    medRxiv

    Abstract: ... to perform over 450 BALs on intubated COVID-19 patients. We therefore sought to describe the subsequent ... that they received. Participants were asked to assess the difficulty of BAL on intubated COVID-19 patients ... BAL. Discussion: At a high-volume center having performed >450 BALs on intubated COVID-19 patients ...

    Abstract Background: The coronavirus disease 2019 (COVID-19) pandemic raised concern for exposure to healthcare providers through aerosol generating procedures, such as bronchoalveolar lavage (BAL). Current society guidelines recommended limiting use of BAL to reduce operators9 risk for infection, yet data on the infection rate for providers after BAL is sparse. Since March 2020, our institution used a modified protocol to perform over 450 BALs on intubated COVID-19 patients. We therefore sought to describe the subsequent infectious risks to providers associated with BAL. Methods: Fifty-two pulmonary and critical care providers (faculty and fellows) at our tertiary-care, urban medical center were surveyed. Survey participants were asked to provide the number of BALs on COVID-19 patients they performed, the number of weeks they cared for intensive care unit (ICU) patients with COVID-19, and the results of any SARS-CoV-2 testing that they received. Participants were asked to assess the difficulty of BAL on intubated COVID-19 patients as compared to routine ICU BAL using a numeric perceived difficulty score ranging from 1 (easier) to 10 (harder). Results: We received forty-seven responses from fifty-two surveyed (90% response rate), with 2 declining to participate. Many respondents (19/45, 42%) spent >5 weeks on an ICU service with COVID-19 patients. The number of BALs performed by providers ranged from 0 to >60. Sixteen of the 35 providers (46%) who performed BALs underwent at least one nasopharyngeal (NP) swab to test for SARS-CoV-2, but none were positive. Twenty-seven of the 35 providers (77%) who performed BALs underwent SARS-CoV-2 serology testing, and only one (3.7%) was positive. Respondents indicated occasionally not being able to follow aerosol-minimizing steps but overall felt BALs in COVID-19 patients was only slightly more difficult than routine ICU BAL. Discussion: At a high-volume center having performed >450 BALs on intubated COVID-19 patients with aerosol-limiting precautions, our survey of bronchoscopists found no positive NP SARS-CoV-2 tests and only one positive antibody test result. While the optimal role for COVID-19 BAL remains to be determined, these data suggest that BAL can be safely performed in intubated COVID-19 patients if experienced providers take precautions to limit aerosol generation and wear personal protective equipment.
    Keywords covid19
    Language English
    Publishing date 2020-09-01
    Publisher Cold Spring Harbor Laboratory Press
    Document type Article ; Online
    DOI 10.1101/2020.08.30.20177543
    Database COVID19

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